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DOI: 10.1055/s-0038-1637285
FACTORS RELATED TO INADEQUATE COLON CLEANSING
Publication History
Publication Date:
27 March 2018 (online)
Aims:
Adequate colon cleansing is mandatory to fulfil colonoscopy quality indicators, so the aim was to evaluate which factors were related to an inadequate colon cleasing.
Methods:
Observational, multicenter cross-sectional study. Colonoscopies performed during 2016. We included patients aged 40 – 80 yo, and four colonoscopy indications: gastrointestinal symptoms (GIS), fecal immunochemical test positive (FIT+), post-polypectomy surveillance (PPS) and primary screening colonoscopy (PSC).
Definition of inadequate colon cleansing: 0 – 1 point using the Boston Bowel Preparation Scale in at least one colon segment.
Results:
8895 colonoscopies were included. 52.5% (4665) were men and the median age 62 years-old. The rate of inadequate colon cleansing was 12.7% (1055). Univariate and multivariate statiscal analysis were performed.
Inadequate colon cleansing resulted in 17.3% (502) of patients with GIS (p < 0.001, aOR2.7, CI 95% 2.2 – 3.2), 14.3% (200) of PPS (p < 0.001, aOR1.9, CI 95% 1.5 – 2.3), 11.1% (70) of PSC (p = 0.003, aOR1.6, CI 95% 1.2 – 2.1) and 8.3% (281) of FIT+.
Also, 13.5% (593) of men (p = 0.001, aOR1.3, CI 95% 1.1 – 1.5) and 13.8% (677) of patients ≥60 yo (p < 0.001, aOR1.3, CI 95% 1.1 – 1.5) had inadequate colon cleansing. Regarding the bowel preparation, 12.6% (242) of PEG4L (p-value: ns), 13.5% (418) of PEG2L (p-value: ns), 11.3% (342) of Napicosulphate/Mgcitrate (SPMC) (p = 0.001, aOR0.8, CI 95% 0.7 – 0.9) were poor prepared. In addition, 11.4% (281) same day (p = 0.005, aOR1.3, CI 95% 1.1 – 1.5), 20.6% (215) day before (p-value: ns) and 11.2% (532) split bowel preparation intake had inadequate preparation.
16.3% (476) of patients who spent > 4h from the end of bowel preparation to the beginning of the procedure (p-value: ns), however 21.7% (282) of those who spent > 7h (p < 0.001, aOR2.8, CI 95% 2.0 – 3.9) had inadequate colon cleansing.
No statiscal differences were found in regards to the working shift nor BMI.
Conclusions:
Colonoscopy indication, sex, age, same day bowel preparation intake and > 7h from the end of bowel preparation intake to the beginning of the procedure were independent factors that increased the risk of inadequate colon cleansing. However, the usage of SPMC was an independent factor that decreased the risk of inadequate colon preparation.